{
  "abstract": "Background: Dietary self-regulation supports healthy eating, but its cross-sectional associations with e-health literacy, perceived stress, and rest intolerance remain unclear. This study characterized dietary self-regulation levels among adults in Shanghai and estimated direct and indirect associations among these variables.\n\nMethods: A cross-sectional survey of 1,011 permanent adult residents of Shanghai was conducted from July to September 2024. Validated questionnaires assessed e-health literacy, dietary self-regulation, perceived stress, and rest intolerance. Associations were examined using Spearman correlations, exploratory latent profile analysis, and a prespecified serial indirect-association model (PROCESS Model 6; 5,000 bootstrap resamples) adjusted for gender, age, education, employment, residence, and income.\n\nResults: The selected three-class solution primarily distinguished low, moderate, and high overall dietary self-regulation, with largely parallel item-response patterns rather than qualitatively distinct subtypes. E-health literacy was positively associated with dietary self-regulation and rest intolerance and negatively associated with perceived stress; perceived stress was negatively associated with dietary self-regulation, whereas rest intolerance was positively associated with it. The total association between e-health literacy and dietary self-regulation was 0.615 (95% CI, 0.564–0.666); the association conditional on perceived stress and rest intolerance was 0.211 (95% CI, 0.147–0.274), and the total indirect association was 0.404 (95% CI, 0.344–0.466). The serial indirect association was small and negative (−0.015; 95% CI, −0.031 to −0.001), and the perceived stress-rest intolerance coefficient reversed direction after adjustment.\n\nConclusion: The variables were interrelated in the prespecified cross-sectional model, but the small serial estimate and directional instability do not support a clear sequential psychological mechanism. Because all variables were measured at one time point, temporal ordering and causal mediation cannot be established, and reverse causality remains possible. These findings are hypothesis-generating and require longitudinal or experimental confirmation.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Critical Care Medicine, General Hospital of Ningxia Medical University",
    "Department of Dermatology, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine",
    "Cardiac Center, General Hospital of Ningxia Medical University"
  ],
  "article_type": null,
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Fang Tian"
    },
    {
      "affs": [
        1
      ],
      "name": "Lin Du"
    },
    {
      "affs": [
        2
      ],
      "name": "Hao Yang"
    },
    {
      "affs": [
        0
      ],
      "name": "Yue Zhang"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/1548b4z86sxc6.bib",
  "cited_by": 0,
  "doi": "10.3389/fpubh.2026.1928922",
  "fulltext_url": null,
  "id": "1548b4z86sxc6",
  "issns": [
    "2296-2565"
  ],
  "landing_url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1928922/full",
  "language": null,
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2916|Nutrition, Health and Food Behavior"
    ]
  ],
  "openalex": "W7223945219",
  "pdf_url": "https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2026.1928922/pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-10-27",
  "publisher": "Frontiers Media SA",
  "ris": "https://research.draconitic.com/paper/1548b4z86sxc6.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:20:24Z",
      "native_id": "10.3389/fpubh.2026.1928922",
      "source": "crossref",
      "url": "https://www.frontiersin.org/articles/10.3389/fpubh.2026.1928922/full"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "issn:2296-2565",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Dietary self-regulation levels among adults in Shanghai: cross-sectional associations with e-health literacy, perceived stress, and rest intolerance",
  "title_text": "Dietary self-regulation levels among adults in Shanghai: cross-sectional associations with e-health literacy, perceived stress, and rest intolerance",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:20:24Z",
  "url": "https://research.draconitic.com/paper/1548b4z86sxc6",
  "venue": "Frontiers in Public Health",
  "versions": []
}